What are parasomnias?
Parasomnias are disruptive sleep-related disorders that can occur
during arousals from rapid eye movement (REM) sleep or arousals from
non-rapid eye movement (NREM) sleep. Parasomnias:
- are characterized by undesirable physical or verbal behaviors,
such as walking or talking during sleep
- occur in association with sleep, specific stages of sleep or
sleep-wake transitions and
- can be divided into two groups—primary parasomnias and secondary
parasomnias.
Primary parasomnias are disorders of sleep states, while
secondary parasomnias are disorders of other organ systems that arise
during sleep.
Primary parasomnias are marked by a simultaneous
occurrence of elements of both wakefulness and sleep. Primary
parasomnias are classified according to the stage of sleep in which they
occur: rapid eye movement (REM) or non–rapid eye movement (NREM).
Secondary parasomnias are disorders of other organ
systems that may take place during sleep. Secondary parasomnias may be
quite common, but can be unrecognized, misdiagnosed, or ignored in
clinical practice.
Types of parasomnias
Nightmares
Nightmares are vivid nocturnal events that can cause feelings of
fear, terror, and/or anxiety. Usually, the person having a nightmare is
abruptly awakened from REM sleep and is able to describe detailed dream
content. Usually, the person having a nightmare has difficulty returning
to sleep. Nightmares can be caused by many factors including illness,
anxiety, the loss of a loved one, or negative reactions to a medication.
Call your doctor if nightmares occur more often than once a week or if
nightmares prevent you from getting a good nights rest for a prolonged
period of time.
Sleep terrors/night terrors
A person experiencing a night terror or sleep terror abruptly awakes
from sleep in a terrified state. The person may appear to be awake, but
appears confused and is not able to communicate. Night terrors last
about 15 minutes, after which time the person usually lies down and
appears to fall back asleep. People who have sleep terrors usually don’t
remember the events the next morning. Night terrors are similar to
nightmares, but night terrors usually occur during stages 3 sleep (deep
sleep). People experiencing sleep terrors may pose dangers to themselves
or others because of jumping on the bed or running around. Night
terrors are fairly common in children aged four to twelve. This sleep
disorder, which may run in families, also can occur in up to 3% of
adults. Strong emotional tension and/or the use of alcohol can increase
the incidence of night terrors among adults.
Sleepwalking (somnambulism)
Sleepwalking occurs when a person appears to be awake and moving
around with eyes wide open but is actually asleep. Sleepwalkers have no
memory of their actions. Sleepwalking most often occurs during deep
non-REM sleep (stage 3), early in the night. These episodes vary widely
in complexity and duration. This disorder is most commonly seen in
children aged six to twelve; however, sleepwalking can occur among
younger children, the elderly, and adults. Sleepwalking appears to run
in families. Sleepwalking can sometimes be dangerous because the
sleepwalker is unaware of his or her surroundings and can bump into
objects or can fall down.
Confusional arousals
Confusional arousals usually occur when a person is awakened from a
deep sleep during the first part of the night. This disorder, which also
is known as excessive sleep inertia or sleep drunkenness, involves an
exaggerated slowness upon awakening. People experiencing confusional
arousals react slowly to commands and may have trouble understanding
questions that they are asked. The childhood form is benign and resolves
spontaneously while the adult variant may persist for a long time with
consequences such as sleep related injury, sub-optimal performance at
work, etc.
Sleep paralysis
People with sleep paralysis are not able to move the body or limbs
when falling asleep or waking up. Brief episodes of partial or complete
skeletal muscle paralysis can occur during sleep paralysis. Sometimes
sleep paralysis runs in families, but the cause of sleep paralysis is
not known. Sleep deprivation and irregular sleep-wake schedules can also
cause sleep paralysis. It is also seen in narcolepsy, a disorder
characterized by severe excessive daytime sleepiness. This disorder is
not harmful, but people experiencing sleep paralysis often are fearful
because they do not know what is happening. An episode of sleep
paralysis often is terminated by sound or touch. Within minutes, the
person with sleep paralysis is able to move again.
REM sleep behavior disorder (RBD)
People with rapid eye movement (REM) sleep behavior disorder act out
dramatic and/or violent dreams during REM sleep. REM sleep usually
involves a state of paralysis (atonia), but people with this condition
move the body or limbs while dreaming. Usually, RBD occurs in men aged
50 and older, but the disorder also can occur in women and in younger
people. In the diagnosis and treatment of RBD, potentially serious
neurological disorders must be ruled out. Polysomnography (sleep study)
and drug treatments are involved in the diagnosis and treatment of this
disorder.
Sleep enuresis
In this condition, also called bedwetting, the affected person is
unable to maintain urinary control when asleep. There are two kinds of
enuresis—primary and secondary. In primary enuresis, a person has been
unable to have urinary control from infancy onward. In secondary
enuresis, a person has a relapse after previously having been able to
have urinary control. Enuresis can be caused by medical conditions
(including diabetes, urinary tract infection, or sleep apnea) or by
psychiatric disorders. Some treatments for bedwetting include
behavior modification, alarm devices, and medications.
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This information is provided by the Cleveland Clinic and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition.This document was last reviewed on: 12/16/2008...#12133
